经脐单孔腹腔镜胆囊切除术10例体会

目的探讨经脐单孔腹腔镜胆囊切除术的可行性.方法 10例胆囊疾病患者（8例息肉,2例结石）行经脐腹腔镜胆囊切除术,采用脐部做一2.0 cm弧形切口,应用脐部操作装置建立腹腔镜操作通道并维持气腹完成胆囊切除.结果 9例手术均获成功,1例手术失败.第1例手术时间为165 min,后续8例手术时间约50～110 min,平均75 min.1例操作失败改行3孔法腹腔镜胆囊切除.未放置引流管,无出血及胆漏等并发症发生,均于术后2 d出院.术后随访脐部无明显手术瘢痕.结论经脐单孔腹腔镜胆囊切除术是安全可行的,切口瘢痕美观、微创,尤其适用年轻女性患者,但操作难度较常规腹腔镜胆囊切除术大,需严格选择适应症.

Experiences of Transumbilical Single Port Laparoscopic Cholecystectomy in Ten Cases

Objective To explore the feasibility of transumbilical single port laparoscopic cholecystectomy.Methods Transumbilical single port laparoscopic cholecystectomy was performed in 10 patients with gallbladder disease（8 cases of polyps and 2 cases of calculus）.2.0 cm curved incision was made in umbilical region of patients,and laparoscopic operation channel was established by using devices and pneumoperitoneum was maintained,then laparoscopic cholecystectomy was performed.Results Transumbilical single port laparoscopic cholecystectomy was performed successfully in 9 patients and was failed in 1 patient.The operation time of the first patient was 165 min,and the operation time of the later 8 patients was in 50～110 min,and 75 min on average.The patient with failed transumbilical single port laparoscopic cholecystectomy received three ports laparoscopic cholecystectomy without placing drain pipe.Patients were discharged from hospital 2 days after operation without complications such as bleeding and bile leakage.No significant operation scar was found in umbilical region of patients after laparoscopic cholecystectomy.Conclusions Transumbilical single port laparoscopic cholecystectomy is safe and feasible,minimally invasive,and without significant scar,is specially suitable for young femal patients.However,the operation of transumbilical single port laparoscopic cholecystectomy is more difficult than conventional laparoscopic cholecystectomy,therefore the indications should be selected strictly.